TARA POWERS BRANTLEY

SAN FRANCISCO, CA
NPI1932685740
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: CA  A182566)
Additional Taxonomies122300000X Dentist
(Licence: CO  00203363)
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: OR  D11766)
208600000X Surgery
(Licence: CA  A182566)
Enumeration Date2018-07-15
Last Update Date2024-08-09
Business Address
Dr. TARA POWERS BRANTLEY MD, DMD
1001 POTRERO AVENUE BLDG. 5, FL. 1. #1N
SAN FRANCISCO, CA 94110-3518
Phone number: 628-206-8104
Mailing Address
Dr. TARA POWERS BRANTLEY MD, DMD
PO BOX 743749
SAN FRANCISCO, CA 90074-3749
Phone number: